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Contact Information

GLENN J WALDT, DO
2803 DORAL CT
LAS CRUCES, NM88011-8616
 Phone: 046-984-4063
 Fax: 877-532-2113
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine & OMM

204D00000X 12 Physician/Osteopathic Manipulative Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for GLENN J WALDT · (Male)

NPI # 1437219698
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 12/11/2006
Last updated 05/08/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # A045921
  • NM Medicaid 27552381
Hospital affiliation(s)
  • MEMORIAL MEDICAL CENTER INC - (Acute Care)
    2450 SOUTH TELSHOR BLVD
    LAS CRUCES, NM 88011
  • MOUNTAIN VIEW REGIONAL MEDICAL CENTER - (Acute Care)
    4311 EAST LOHMAN AVENUE
    LAS CRUCES, NM 88011
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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